When my husband and I traveled to Peru last fall, I was lucky I could depend on his fluency rather than my own supremely limited Spanish. He could engage the waiter or hotel receptionist in a rapid, dizzying exchange, while I tried to hide my dazed expression. It was an eye-opening experience and made me appreciate the challenges of people who live in the United States with low English proficiency.
There are an estimated 312,000 Coloradans who do not speak English very well or at all. Without question, not speaking a region’s predominant language complicates anyone’s ability to access health care services. If you don’t speak the same language as your health care provider, it would be challenging for you to understand the diagnosis or instructions you need to follow to get or stay healthy. Medicare, Medicaid, and CHP+ require all their contracted providers to offer language interpreters, even though they may not always get paid for it. In Colorado, Medicaid and CHP+ programs do not reimburse providers for that service, so those costs come out of the provider’s bottom line. This can result in the hiring of less-expensive, lower-quality interpretation services.
CCMU recently had the opportunity to learn from Coloradans who spoke only Karen (the Burmese language) or Spanish about how difficult it can be to access health care services. With the help of interpreters, we learned that their experience with effective interpretation in medical settings was mostly negative. Phone interpreters weren’t always reliable; they shared that some were rude or unprofessional, or had withheld or misrepresented information to their provider. When no interpretation services were available, their children might interpret for them despite the sensitive nature of the topics. Patients without even that option reported having such a poor experience they chose to no longer seek preventive care, limiting their health care interactions to emergencies only.
Unsurprisingly, research supports the connection between language barriers and health; namely, worse health status, a lower likelihood of having a usual source of care, lower rates of preventive care, and an increased risk of drug complications. And, you’re more likely to return to the emergency room within days of being discharged. Since language barriers have a direct link to a person’s health outcomes, it is critical for us to improve this aspect of health care delivery by ensuring that all patients have access to high-quality interpretation services.
I remember how vulnerable I felt when I couldn’t communicate in Spanish, and that was with an effective interpreter in a low-stress situation. When you’re seeking care, you’re already in a vulnerable and potentially high-stress place, and not speaking or understanding the language significantly increases that vulnerability. No one deserves to feel that way, and we have an opportunity to make sure no one does.